The dacryocanalicular preparation method of a kind of degradable artificial
Technical field
The present invention relates to the dacryocanalicular preparation method of a kind of degradable artificial, relate in particular to a kind of degradable type artificial lacrimal duct method of making fast by the approach that forms gel column, with its treatment obstructed lacrimal passage and dacryocystisis, belong to ophthalmology artificial lacrimal duct technical field clinically.
Background technology
In ophtalmic treatments, cases such as the obstructed lacrimal passage that is caused by the various different causes of disease, urgency/chronic dacryocystitis are more and more, account for 3% of ophthalmology clinic case, because of many tears or excessive tear that obstructed lacrimal passage causes bring very big inconvenience for patient's life and work.At present, the method for treatment obstructed lacrimal passage commonly used is that machinery or laser spy are logical, washes repeatedly with liquid medicine then.But insoluble difficulty is that former obstructive position was easily organized adhesion again after spy was led to for the first time, cause lacrimal passage to stop up once more or narrow, often need repeatedly to visit logical operation, this has increased many troubles to the ophthalmologist, has also brought great inconvenience and financial burden to the patient.In addition, in repetitious spy by in the journey, the friction major injury of hard operating theater instruments normal lacrimal passage inwall, totally unfavorable to patient's lacrimal passage functional rehabilitation.
In recent years, along with the application of artificial lacrimal duct, alleviated the trouble and the medical expense of repeatedly performing the operation and being brought greatly when improving curative effect, therefore, increasing ophthalmologist adopts method treatment obstructed lacrimal passage and the dacryocystisis of inserting artificial tear duct.But what generally use at present is nondegradable silica gel tube or other medical rubber hoses.Though carried out a large amount of technological improvements in the past, even in conjunction with different auxiliary facilities treatments, still need to carry out second operation taking-up tubule after can working as Wound healing, this process can make new healing position once more because of the friction damaged, not only increased great misery to the patient, even the possibility of " recurrence " is arranged, have a strong impact on therapeutic effect.Do not degrade for a long time as the material of implanting, reaction easily also causes inflammation in lacrimal passage.
At present, have bibliographical information: after collagen protein, chitosan and polyvinyl alcohol are mixed according to a certain percentage, make porous or fine and close composite membrane, have good mechanical performance and biocompatibility.Relevant patent report is also arranged: make degradable lacrimal point thromboembolism after collagen protein, chitosan and polyvinyl alcohol are mixed according to a certain percentage, be used for the treatment of xerophthalmia.But do not see the relevant report that collagen protein, chitosan and polyvinyl alcohol is prepared into artificial lacrimal duct.
Summary of the invention
The purpose of this invention is to provide the good degradable type artificial lacrimal duct of a kind of biocompatibility, its hardness and toughness are moderate during dry state, soft smooth after the swelling, can be used for the obstructed lacrimal passage position is visited logical back and supports the lacrimal passage inwall and prevent adhesion again or narrow, it is finally biodegradable to cure the back material, and product flows out with tear.
The technical barrier that the present invention will solve is:
(1) biocompatibility of material, biodegradability;
(2) lacrimal ductule mechanics support performance, the operability of operation;
(3) hemostasis, antibacterial, the effect that promotes wound healing are arranged;
(4) effectively support obstructive position, prevent slippage;
(5) stop adhesion again or " recurrence ";
(6) material degradable behind the wound healing need not second operation and takes out, and avoids lacrimal passage impaired once more.For realizing above purpose, technical scheme of the present invention provides the dacryocanalicular preparation method of a kind of degradable artificial,
It is characterized in that by the process of circulating frozen/thaw, its method is:
The first step. in 90 ℃ water-bath, medical PVA PVA-124 granule is dissolved in the water for injection, is mixed with transparent 5~10% (w/w) poly-vinyl alcohol solution;
Second step. at ambient temperature, the chitosan of deacetylation 〉=90% is dissolved in the acetic acid solution of 1~2% (w/w), stirred 16 hours-24 hours,, be mixed with 2~4% (w/w) chitosan solution, 2 ℃~8 ℃ cold preservations until dissolving fully;
The 3rd step. the cattle heel string that pepsin digestion, acetum extracting are cleaned, therefrom extract I collagen type solution, concentration 〉=0.5% (w/w), 2 ℃~8 ℃ cold preservations;
The 4th step. according to a certain percentage with above-mentioned three kinds of solution stirring and evenly mixing in ice bath: the weight ratio of collagen chitosan solution is 5/5~9/1, and the weight ratio that poly-vinyl alcohol solution accounts for total solution is 7%~50%, stirs 1 hour-2 hours;
The 5th step. slowly drip the NaOH solution of 2M when stirring, the pH value of regulating mixed liquor is near neutral, and stable back continues to stir half an hour;
The 6th step. solution in the step 5 is placed refrigerator cold preservation deaeration in-24 hours in 16 hours;
The 7th step. solution in the step 6 is sucked in the syringe of 20ml, put the 12# syringe needle, in the tubular plastic mould of end sealing, inject mixed solution;
The 8th step. mould is placed-20 ℃ refrigerator-freezer freezing 10 hours-14 hours, take out then, place room temperature to thaw 10 hours-14 hours, freezing again 10 hours-14 hours, so circulate 5~7 times;
The 9th step. pass from elastic gel post center with diameter 0.5~0.7mm medical puncture needle, erect;
The tenth step. the gel column of threading a needle in the step 9 is put into water for injection soak half an hour;
The 11 step. the gel column in the step 10 is erect natural drying in room temperature;
The 12 step. exsiccant gel column is slowly released from puncture needle;
The 13 step. the two ends with scalpel vertically cuts away tubule, can get internal diameter 0.5~0.7mm, external diameter is 0.9~1.5mm, the toughness lacrimal ductule of length 〉=20mm.
The 14 step. pack in the polyethylene valve bag pruning good lacrimal ductule in the step 13, seal standby.
In order to prolong the degradation time of artificial lacrimal duct in lacrimal passage, need in preparation process, in type gel column to be carried out chemical crosslinking, therefore, increased cross-linking process, the gel column that is about to thread a needle in the step 9 is soaked in≤0.25% glutaraldehyde solution in 0.5 hour, take out back flushing repeatedly in water for injection, get final product according to step 10~14 operations then.
The method of the gel column that described step 9 is threaded a needle also can be inserted the pore-creating of hard round bar in the middle of the good pluralgel post of elasticity, and fixes, dewaters as support bar with it.
The present invention selects for use behind biodegradable I collagen type and chitosan and the medical PVA uniform mixing approach that forms gel column by freeze/thaw repeatedly to make biodegradable novel artificial lacrimal ductule.
Collagen protein (Collagen) is called for short collagen, is the Main Ingredients and Appearance of connective tissue in the mammalian body, accounts for 30% in human body protein.Dissimilar collagen protein participates in the composition of different tissues extracellular matrix in vivo, and wherein the I collagen type also participates in the structure of bone except the composition that participates in skin and tendon.Collagen protein be a kind of wide material sources, good biocompatibility, avirulence, non-immunogenicity, can be in vivo the biomaterial of katabolism rapidly.In addition, collagen protein also participates in the organization healing process, has the effect of quick-acting haemostatic powder and promotion wound healing, and the I collagen type sponge of extracting from the cattle heel string that Qisheng Biopreparations Co., Ltd., Shanghai produces has been widely used in clinical as sthptic sponge.Collagen also is widely used in organizational project, for example artificial skin, nerve trachea, artificial blood vessel etc.Also have collagen protein is carried out a large amount of research as drug carrier material.Collagen protein also can form good biodegradable and absorbable composite material with chitosan, hyaluronic acid, chondroitin sulfate, polylactic acid, hydroxyapatite etc., as artificial dressing and tissue substitute material.
Chitosan has another name called chitosan (Chitosan), is by biosynthetic natural polysaccharide, is the product of de-acetyl chitin.Chitosan is the rare polymer that has positive charge, have avirulence, nonirritant, degradability and good biocompatibility, because containing some, it helps cell adhesion and the information that keeps the cell differentiation function simultaneously, non-immunogenicity, and can be compound with the other biological medical material.Great deal of research results show this chitosan have hemostasis, antibacterial, promote epithelial cell growth, prevent the tissue adhesion, promote effect such as wound healing, what the aqueogel of being made by chitosan had been widely used in preventing in the gynecilogical operation promoting in intestinal adhesion, the injection of joint chamber cartilage forms and prevents aspects such as adhesion of tendon and ophthalmology.At present, the research of sensitivity aquagel, nano-scale chitosan granule, chitosan tiny balloon etc. has become people's research focus, also add chitosan with effective performance of improving material in engineering material, the bio-medical composition in a organized way, on market, also there is increasing multi-form chitosan product to occur, hence one can see that, and chitosan is paid close attention to by increasing biomedical researcher.
(polyvinyl alcohol is the water soluble polymer that contains great amount of hydroxy group on a kind of strand side group PVA) to polyvinyl alcohol, and it generally is the product that is obtained through hydrolysis, alcoholysis or aminolysis by polyvinyl acetate.Common medical PVA has PVA05-88, PVA17-88 and PVA-124.Used polyvinyl alcohol is the medical grade PVA-124 of import packing among the present invention, and it has excellent biological compatibility, film property, mechanical property etc.Polyvinyl alcohol is widely studied and applied as aspects such as artificial cartilage, drug delivery system, microcapsule coating technology, ophthalmology, anticoagulation and intelligent biomaterials at biomedical engineering field.In ophthalmology, the cornea of being made by polyvinyl alcohol has good biological stability and light transmission, and the artificial tears who is mixed with by polyvinyl alcohol embodies good moistening effect in dry eye treatment.And polyvinyl alcohol hydrogel is a kind of containing to enrich the elastic hydrogel that micropore can comprise large quantity of moisture, it has characteristics such as lubricated, good toughness, crosslinked polyvinyl alcohol gel is usually used in developing artificial ligament, artificial cartilage etc., shows good mechanical performance and biocompatibility.Because the mechanical property that polyvinyl alcohol is outstanding is added a certain amount of polyvinyl alcohol usually when the preparation composite, the mechanical property of composite can greatly be improved.
In the present invention, unique process of passing through circulating frozen/thaw makes the homogeneous mixture solotion that contains certain proportion polyvinyl alcohol and collagen and chitosan form ganoid even elastic composite gel column, and one-step shaping has been avoided the introducing of other impurity.Each composition of dried artificial lacrimal duct is evenly distributed, and surfaces externally and internally is smooth, and shape is translucent, intensity and tough sexual compatibility operation technique, not easy fracture or distortion, and in dehydration, can keep pore constant, the gel synchronous, the easy demoulding of dried lacrimal ductule, tube wall is more even, kept the network structure that runs through mutually between the different high molecular strands, this artificial lacrimal duct absorbs water after inserting lacrimal passage fast, swelling, becomes softish elastic hollow gel tube, and the patient does not have obvious foreign body sensation.
In the present invention, change the ratio of collagen and chitosan, after the same method, can prepare the degradable artificial lacrimal ductule of a series of different components fast, its degradation time also can be done the adjustment of certain limit, and as seen this invention is a kind of new method of preparation degradable type artificial lacrimal duct of simple to operate, practical.
Advantage of the present invention is:
A) preparation method is simple, efficient;
B) composition is evenly distributed, and mechanical property is good, is convenient to operation;
C) material non-toxic, vacuum response, biocompatibility is good;
D) have quick-acting haemostatic powder, antibacterial, anti, promotion and visit logical position wound healing;
E) quick suction formed elastic smooth gel tube after this tubule was met tear, did not damage the lacrimal passage inwall during operation;
F) form the resilient flexible gel behind the water absorption and swelling, can mechanically locate and not have foreign body sensation;
G) material is finally biodegradable, and catabolite can flow out with tear;
H) need not second operation after the healing takes out.
The specific embodiment
The invention will be further described below in conjunction with embodiment.
Embodiment
Embodiment 1
The dacryocanalicular preparation method of a kind of degradable artificial is:
The first step. in 90 ℃ water-bath, medical PVA PVA-124 granule is dissolved in the water for injection, is mixed with transparent 5~10% (w/w) poly-vinyl alcohol solution;
Second step. at ambient temperature, the chitosan of deacetylation 〉=90% is dissolved in the acetic acid solution of 1~2% (w/w), stirred 16 hours-24 hours,, be mixed with 2~4% (w/w) chitosan solution, 2 ℃~8 ℃ cold preservations until dissolving fully;
The 3rd step. the cattle heel string that pepsin digestion, acetum extracting are cleaned, therefrom extract I collagen type solution, concentration 〉=0.5% (w/w), 2 ℃~8 ℃ cold preservations;
The 4th step. take by weighing 90g 1% collagen solution and 10g 2% chitosan solution, stirring and evenly mixing in the ice bath adds 50g 10% poly-vinyl alcohol solution, stirs 1 hour mixing, forms even translucent viscous solution to mixed solution;
The 5th step. slowly drip the NaOH solution of 2M when stirring, the regulator solution pH value is 7.04, continues to stir half an hour;
The 6th step. solution in the step 5 is placed 2 ℃~8 ℃ cold preservation of refrigerator deaeration in 18 hours;
The 7th step. solution in the step 6 is sucked in the syringe of 20ml, put the 12# syringe needle, in the tubular plastic mould of end sealing, inject mixed solution;
The 8th step. mould is placed-20 ℃ freezing 13 hours of refrigerator-freezer, take out then, place 20 ℃ of room temperatures to thaw 10 hours, freezing again 13 hours, so circulate 5 times;
The 9th step. pass from elastic gel post center with diameter 0.7mm medical puncture needle, erect;
The tenth step. the gel column of threading a needle in the step 9 is put into water for injection soak half an hour;
The 11 step. the gel column in the step 10 is erect natural drying in room temperature;
The 12 step. exsiccant gel column is slowly released from puncture needle;
The 13 step. the two ends with scalpel vertically cuts away tubule, can get internal diameter 0.5~0.7mm, external diameter is 0.9~1.5mm, the toughness artificial lacrimal duct of length 〉=20mm;
The 14 step. pack in the polyethylene valve bag pruning good lacrimal ductule in the step 13, seal standby.
Embodiment 2
Take by weighing 70g 1% collagen solution and 30g 2% chitosan solution, stirring and evenly mixing in the ice bath.Add 50g 10% poly-vinyl alcohol solution, continue stirring and evenly mixing, form even translucent viscous solution to mixed solution, slowly drip the NaOH solution of a little 2M while stirring, the regulator solution pH value is 7.08, continues to stir half an hour, leaves standstill an evening under the low temperature.Draw uniform mixing liquid with syringe, put syringe needle, solution is injected mold, then in-20 ℃/20 ℃ freeze/thaw 5 times repeatedly, take out pillared elastic composite gel, in the middle of the pluralgel post, insert the pore-creating of hard round bar, put into water for injection again and cleaned 30 minutes, erect, the room temperature natural air drying, two is pruned in the demoulding, encapsulation, all the other are identical with embodiment 1.
Embodiment 3
Take by weighing 30g 1% collagen solution and 20g 2% chitosan solution, stirring and evenly mixing in the ice bath adds the 25g10% poly-vinyl alcohol solution, continues stirring and evenly mixing, forms even translucent viscous solution to mixed solution.Slowly drip the NaOH solution of a little 2M while stirring, the regulator solution pH value is 6.89, continues to stir half an hour, leaves standstill an evening under the low temperature.Draw mixed liquor with syringe, put syringe needle, solution is injected mold, in-20 ℃/20 ℃ freeze/thaw 5 times repeatedly, take out pillared pluralgel then, the 7# puncture needle is passed the gel column central shaft, the gel column of threading a needle is soaked in≤0.25% glutaraldehyde solution in 0.5 hour, take out back flushing repeatedly in water for injection, erect the room temperature natural air drying, the demoulding, shear two, encapsulation, all the other are identical with embodiment 1.
Embodiment 4
Take by weighing 33.3g 1% collagen solution and 16.7g 2% chitosan solution, stirring and evenly mixing in the ice bath adds 10g 10% poly-vinyl alcohol solution, continues stirring and evenly mixing, forms even viscous solution to mixed solution.Slowly drip the NaOH solution of 2M while stirring, dropped to when a little white floccule occurs and stopped, stir the back dissolving, continued stir about 3 hours, and reduced mixing speed then gradually, the bubble in the solution is slowly discharged, draw mixed liquor with syringe, put syringe needle, solution is injected mold, then in-20 ℃/20 ℃ freeze/thaw 7 times repeatedly.Take out the elastic composite gel,, put into water for injection and cleaned 30 minutes by the gel center with puncture needle, erect, room temperature is air-dry, and the tubule two ends are pruned in the demoulding, encapsulation, and all the other are identical with embodiment 1.
Embodiment 5
Take by weighing 27g 1% collagen solution and 27g 2% chitosan solution, stirring and evenly mixing in the ice bath adds the 27g10% poly-vinyl alcohol solution, continue stirring and evenly mixing, form even viscous solution to mixed solution, slowly drip the NaOH solution of 2M while stirring, the regulator solution pH value is 7.02, continue to stir half an hour, leave standstill an evening under the low temperature, draw mixed liquor, put syringe needle with syringe, solution is injected mold, then in-20 ℃/20 ℃ freeze/thaw 5 times repeatedly.Take out pillared elastic composite gel, the 7# puncture needle by the gel column central shaft, is put into 0.25% glutaraldehyde solution again and soaked 30 minutes, put into water for injection after the taking-up and clean repeatedly, erect, room temperature is air-dry, the demoulding, excision two, encapsulation, all the other are identical with embodiment 1.
It is 0.5~0.7mm that the present invention prepares internal diameter, and external diameter is 0.9mm~1.5mm, and the hollow toughness tubule of length 〉=20mm is to be applicable to the needs of different clinical operations.
During the treatment obstructed lacrimal passage, visit logical obstructive position earlier, inserting dacryocanalicular method has:
(1) inserts if desired from the nearer position of lacrimal point, can directly push from lacrimal point lentamente;
(2) if be inserted into from lacrimal point position far away, lacrimal ductule can be enclosed within on the tiny draught line, joint is beaten at online middle part, by syringe, earlier draught line is introduced nasal cavity from lacrimal point, drive draught line lacrimal ductule slowly is pulled to the position of visiting after leading to, stop one and oppositely take out draught line after the meeting;
(3) lacrimal ductule can be enclosed within on the fine needle head, slowly be pushed into obstructive position, stop and oppositely take out syringe needle after 10~30 minutes.
Contained collagen protein has the effect of quick-acting haemostatic powder, promotion wound healing in this lacrimal ductule to the probing of lacrimal passages position, that chitosan has is antibacterial, anti, anti-cicatrix effect, the medical PVA of biocompatibility and good mechanical properties can play effective supporting during treating, after the healing of lacrimal passage damaged part, this artificial lacrimal duct is biodegradable, catabolite flows out with tear, need not second operation and takes out, and it is impaired to have avoided the lacrimal passage inwall to rub once more.
The degradation behavior test of this lacrimal ductule in PBS solution: the artificial lacrimal duct that clip 10mm is long, put into the PBS solution of the pH=7.4 of 5ml, sealing is deposited in 70 ℃ the baking oven.The result: two days later, the good lacrimal ductule of elasticity becomes white pasty state originally.Show this lacrimal ductule degradable, the form after the degraded is the liquid body, can flow out voluntarily with tear, need not second operation and takes out, and has avoided normal lacrimal passage inwall to be scratched.In addition because of wherein contained collagen has quick-acting haemostatic powder, promotes the wound healing effect, that chitosan has is antibacterial, the effect of anti-cicatrix, and the good mechanics support effect of PVA can effectively improve the curative effect for the treatment of obstructed lacrimal passage and urgency/chronic dacryocystitis in addition.
Table one: the novel artificial lacrimal ductule of this invention preparation and the silica gel tube performance comparison table that uses at present.